Inside Health

Was there ever a golden age in which to train to be a doctor?

Vivienne Parry asks if the NHS can deliver the benefits of genomic medicine for all

With over 50 confirmed cases of people in the UK with the Zika, Dr Margaret McCartney reviews the latest advice for people worried about the virus. Keyhole surgery for the hip. Dr Mark Porter finds out how hip arthroscopy is increasingly being used to treat problems caused by hip impingement. Sion Glyn Jones, Professor of Orthopaedic Surgery at the University of Oxford and consultant orthopaedic surgeon at the Nuffield Orthopaedic Centre describes which groups appear to benefit most from hip arthroscopy, and Amanda, who had to wait 8 years before keyhole surgery on one of her painful hips, tells Mark about the transformation the operation made to her life. Mark and Margaret discuss the benefits of the "yellow card" system, which allows patients and health professionals to report side effects of drugs.And, as more and more people in the UK are surviving, or living with cancer, thanks to recent advances in treatment, choosing the best approach when faced with a life-limiting disease can be difficult. When cure rates approach 100% for early bowel cancer, advising a patient to have surgery is much easier than recommending aggressive chemotherapy for a hard-to-treat tumour when there's only a slim chance of a cure. Consultant oncologist Sam Guglani, from Cheltenham General Hospital, discusses with Mark the different factors that can influence and impact on the unique relationship between doctor and patient when faced with such choices.

Has media coverage of statins caused people to come off the drugs? An unusual neurological itch on the arms or back that is often misdiagnosed. Plus Ghrelin, the hormone that makes your tummy rumble and an unexpected surgical side effect that may help in the quest for people to lose weight. And the story of how Viagra was discovered.

Every three minutes somebody in the UK develops dementia, so when it's claimed that tailored computer brain training can reduce cases of dementia and cognitive decline by a third over a decade, people sit up and take notice. The research claiming the 33% reduction for the group of people whose "processing function" was targeted for brain training, hasn't yet been published - so isn't peer-reviewed - but the preliminary data by a US team was presented to the Alzheimer's Association International Conference in Toronto this week. Dr Doug Brown, Director of R&D at the UK's Alzheimer's Society speaks from the Canadian conference to Dr Mark Porter and says there's widespread excitement about the potential of brain training to protect against dementia. Dr Margaret McCartney urges caution, warning it's too early to make claims before the full data is available.James is a young man with a high pressure sales job, but every year in the summer months he is crippled by agonising headaches. He's one of the 100,000 people in the UK who suffers from cluster headaches, so called because they come in disabling bouts, lasting for 4-6 weeks at a time. Inside Health visits a new one-stop multidisciplinary rapid-access headache clinic at St Thomas's Hospital in London, where James is getting treatment. Dr Giorgio Lambru, who heads the new service, tells Mark why it's so vital that patients with cluster headaches have to be seen, diagnosed and treated quickly.Years after cardiac rehabilitation became a standard part of therapy for heart attacks, the same post-treatment care still isn't routinely available for people who've had cancer, despite decade-old guidance from NICE suggesting that it should be. The UK's first clinical trial to measure holistic cancer care is hoping to provide the evidence that will demonstrate the type of support and rehabilitation that really works. Professor of Nursing Annie Young from Warwick Medical School and University Hospitals Coventry and Warwickshire NHS Trust tells Mark that after treatment, patients can feel abandoned and vulnerable.#hellomynameis is a hugely successful social media campaign which highlights the importance of healthcare staff introducing themselves to patients. It was launched by Dr Kate Granger after her experience of being in hospital. Kate died at the weekend from cancer, aged just 34. Dr Margaret McCartney describes the enormous impact of Kate's campaign throughout the NHS.

What is Papilloedema? The condition has been in the headlines as an optometrist was found guilty of manslaughter after missing abnormalities in the eyes of an eight year old child. Plus, Margaret McCartney debates the accuracy of screening young people for Sudden Cardiac Death in Sport. How to diagnose early miscarriage in women who are bleeding in early pregnancy? And the serendipitous story of how the anti-clotting agent warfarin was first discovered.

Care.data, the scheme to build an enormous database containing the medical records of all English patients has been scrapped. Dr Mark Porter investigates the fall-out following the cancellation of this expensive programme, which foundered on concerns about confidentiality and public and professional trust. Chair of the national EMIS user group and Sheffield GP Dr Geoff Schrecker and GP Dr Margaret McCartney discuss the scale of the failure of the care.data programme and outline what needs to happen in the future if valuable patient data is to be used for the public good.Twelve hundred adults and children die every year in the UK from asthma attacks, and these grim statistics have remained stubbornly consistent for decades. But there is light on the horizon as researchers in the field begin to stratify the disease; identifying patients with different types of asthma and treating them accordingly. Mark visits the Churchill Hospital in Oxford where some pioneering work has taken place to develop new diagnostic tests and new treatments. Ian Pavord, Professor of Respiratory Medicine at the Nuffield Department of Medicine, shows Mark the new FENO breath test for nitric oxide to test inflammation - soon to be available for use in general practice.Acne Rosacea is a debilitating and painful condition. It's characterised by redness, spots and inflammation on the face and affects both sexes but mainly women. Dr Bav Shergill of the British Association of Dermatologists discusses latest treatments.And the first in a new series dedicated to happy accidents that have altered modern medicine. First off, the pacemaker. Dr Margaret McCartney and Carl Heneghan, Professor of Evidence Based Medicine at the University of Oxford, tell the remarkable story of the serendipitous discovery of this life-saving device.

David Haslam, chair of NICE, discusses with Mark Porter how doctors should treat patients with 'multi-morbidity', the millions of people receiving many different drugs for many different conditions. There's plenty of trial data for starting treatments, but a dearth of evidence for stopping them! And one-shot radiotherapy during surgery for breast cancer may help 20,000 women in the UK. Rather than daily hospital visits for radiotherapy over 5 weeks, a dose is given straight to the open wound during the operation. It is quicker, cheaper and much more convenient, so why isn't it more widely available?

NHS health checks or 'mid-life MOTs' have hit the headlines as new research claims they are a success. The aim is prevention - of diabetes, heart attacks and strokes - but their introduction has been controversial amid criticism they are not evidence based or cost effective. Resident sceptic Dr Margaret McCartney debates the issues with National Clinical Advisor Dr Matt Kearney.And putting the family back into planning. As more couples leave it later before starting a family there is growing concern from fertility experts that many people don't know enough about when female fertility starts to decline. Professor Adam Balen and Professor Joyce Harper discuss the issues. And how accurate is the perception, often reported in the media, that fertility 'drops off a cliff' in the mid to late thirties? Professor Richard Anderson reviews the so called 'broken stick' study, a mathematical model which first defined the sharp drop off of female fertility.And another instalment of Inside Language where Dr Margaret McCartney and Professor Carl Heneghan examine the terms used in evidence based medicine and why they matter. This week, adjustment and how researchers allow for factors that might skew their findings.

The average five-year-old consumes their own body weight in sugar every year in this country - a scary illustration of the scale of the sugar problem. The new sugar tax is supposed to tackle this, but what's the evidence that a tax on sugary drinks alone will make a difference? Dr Margaret McCartney reviews the evidence from other countries, which have also used fiscal measures to nudge their populations into eating a healthy diet.PrEP - pre-exposure prophylaxis - is the latest advance in the ongoing battle against HIV. Studies show this preventive HIV therapy can reduce the risk of HIV infection by 86%. So the announcement by NHS England that it wasn't its responsibility to commission the drug has been met by shock and disappointment. Sexual Health and HIV consultant, Dr Jake Bayley, tells Mark that PrEP is a game changer in preventing HIV in high risk groups and the news that it won't be rolled out nationally, as expected, means the UK is falling behind in HIV prevention."We don't like to talk about our bottoms", Maureen Williams tells Inside Health is one reason why take up of bowel cancer screening across the country is so patchy. Maureen was one of the first people to receive the faecal occult blood test ten years ago as part of the roll out of the bowel cancer screening programme and despite having no symptoms, they found early stage bowel cancer. Ten years later Maureen campaigns for people to complete and return the potentially life-saving test. The clinical head of the Scottish Bowel Cancer Screening Programme talks to Mark about the new, simpler screening test called FIT, the Faecal Immunochemical Test, due to be rolled out in Scotland, and perhaps soon in the rest of the UK as well.Researchers in Taiwan have concluded that most patients who undergo surgery can start showering 48 hours after an operation - a finding that flies in the face of traditional thinking that scars need to be kept dry and under a dressing for a week or more, before getting wet. Consultant Surgeon Nicholas Markham from North Devon District Hospital details the dramatic changes for patients undergoing surgery, including keyhole surgery, changes in the use of anaesthetic, access to food and water and bed rest.